Colorectal cancer screening in Australia: an economic evaluation of a potential biennial screening program using faecal occult blood tests

Stone, C. A., Carter, R. C., Vos, T. and St John, J. (2004) Colorectal cancer screening in Australia: an economic evaluation of a potential biennial screening program using faecal occult blood tests. Australian And New Zealand Journal of Public Health, 28 3: 273-282. doi:10.1111/j.1467-842X.2004.tb00707.x


Author Stone, C. A.
Carter, R. C.
Vos, T.
St John, J.
Title Colorectal cancer screening in Australia: an economic evaluation of a potential biennial screening program using faecal occult blood tests
Journal name Australian And New Zealand Journal of Public Health   Check publisher's open access policy
ISSN 1326-0200
Publication date 2004
Sub-type Article (original research)
DOI 10.1111/j.1467-842X.2004.tb00707.x
Volume 28
Issue 3
Start page 273
End page 282
Total pages 10
Editor J Daly
J Lumley
Place of publication Australia
Publisher Public Health Association of Australia
Collection year 2004
Language eng
Subject C1
321202 Epidemiology
730308 Health policy economic outcomes
Abstract Objective: To evaluate whether the introduction of a national, co-ordinated screening program using the faecal occult blood test represents 'value-for-money' from the perspective of the Australian Government as third-party funder. Methods: The annual equivalent costs and consequences of a biennial screening program in 'steady-state' operation were estimated for the Australian population using 1996 as the reference year. Disability-adjusted life years (DALYs) and the years of life lost (YLLs) averted, and the health service costs were modelled, based on the epidemiology and the costs of colorectal cancer in Australia together with the mortality reduction achieved in randomised controlled trials. Uncertainty in the model was examined using Monte Carlo simulation methods. Results: We estimate a minimum or 'base program' of screening those aged 55 to 69 years could avert 250 deaths per annum (95% uncertainty interval 99-400), at a gross cost of $A55 million (95% UI $A46 million to $A96 million) and a gross incremental cost-effectiveness ratio of $A17,000/DALY (95% UI $A13,000/DALY to $A52,000/DALY). Extending the program to include 70 to 74-year-olds is a more effective option (cheaper and higher health gain) than including the 50 to 54-year-olds. Conclusions: The findings of this study support the case for a national program directed at the 55 to 69-year-old age group with extension to 70 to 74-year-olds if there are sufficient resources. The pilot tests recently announced in Australia provide an important opportunity to consider the age range for screening and the sources of uncertainty, identified in the modelled evaluation, to assist decisions on implementing a full national program.
Keyword Public, Environmental & Occupational Health
Cost-effectiveness Analysis
Population
Q-Index Code C1

 
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Created: Wed, 15 Aug 2007, 04:08:43 EST